Postoperative functional rehabilitation for cervical spondylotic myelopathy: An integrative review guided by Orem's self-care deficit theory.

Background: Cervical spondylotic myelopathy is the predominant cause of spinal cord dysfunction in adults, for which surgical decompression remains the mainstay of treatment. Surgical success alone does not guarantee functional restoration, and postoperative rehabilitation is a critical determinant of long-term outcome. A comprehensive, theory-grounded nursing framework to guide rehabilitation practice for this population has not been available. Objectives: To synthesise the current evidence on postoperative rehabilitation nursing for patients with cervical spondylotic myelopathy, to develop a theory-informed nursing framework anchored in Orem's Self-Care Deficit Nursing Theory, and to identify research gaps and priorities. Design: Integrative review following the methodology of Whittemore and Knafl, with reporting guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement where applicable. Information sources: PubMed/MEDLINE, CINAHL Complete, Web of Science Core Collection, Embase and OpenAlex, together with reference-list screening, searched for reports published between January 2014 and January 2025. Methods: Two reviewers independently screened records, extracted data and appraised methodological quality using instruments appropriate to each study design. A theory-driven narrative synthesis with thematic analysis was performed, and the findings were mapped onto the constructs of Orem's theory. Results: Fifty-one studies met the inclusion criteria. Four synthesis domains were identified: risk stratification and acute-phase management; phased functional exercise rehabilitation; pain management and psychobehavioural support; and long-term follow-up and telerehabilitation. Psychological barriers were prominent; a single-centre study reported a kinesiophobia prevalence of 75.4% after surgery, although this estimate derives from limited evidence and requires confirmation in larger, multi-centre cohorts. A Rehabilitation Nursing System Selection Framework was developed to operationalise the constructs of Orem's theory as a conceptual basis for individualising postoperative nursing care. Conclusion: Effective postoperative rehabilitation after surgery for cervical spondylotic myelopathy requires concurrent attention to physical and psychological dimensions. The kinesiophobia prevalence reported in individual studies suggests that screening for psychological barriers may help identify patients who could benefit from additional psychological or behavioural support alongside physical rehabilitation. The proposed framework provides a foundation for developing standardised nursing protocols and for advancing intervention research in this field. Registration: Registered retrospectively with the Open Science Framework Registries (https://osf.io/4jh7q) on 12 December 2025.